SLEEP AND ANTIBODY RESPONSE TO HEPATITIS B VACCINATION
Sleep and Antibody Response to Hepatitis B Vaccination
Aric A. Prather, PhD1,2; Martica Hall, PhD3; Jacqueline M. Fury, BS1; Diana C. Ross, MSN, RN1; Matthew F. Muldoon, MD, MPH4; Sheldon Cohen, PhD5; Anna L. Marsland, PhD, RN1
1Behavioral Immunology Laboratory, Department of Psychology, University of Pittsburgh, Pittsburgh, PA; 2Robert Wood Johnson Foundation Health and Society Scholar jointly appointed in the Center for Health and Community at the University of California, San Francisco and the School of Public Health at the University of California, Berkeley, CA; 3Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; 4Center for Clinical Pharmacology, University of Pittsburgh School of Medicine; Department of Psychology, Carnegie Mellon University, Pittsburgh, PA; 5Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
Experimental evidence links poor sleep with susceptibility to infectious illness; however, it remains to be determined if naturally occurring sleep is associated with immune responses known to play a role in protection against infection. The aim of this study was to determine whether sleep duration, sleep efficiency, and sleep quality, assessed in the natural environment, predict magnitude of antibody responses to a novel antigen among community volunteers in midlife.
Measurements and Results:
Healthy midlife adults (n = 125; 70 female; age 40-60 yr) received the standard 3-dose hepatitis B vaccination series. Actigraphy and electronic sleep diaries were used to assess sleep duration, sleep efficiency, and subjective sleep quality. Viral-specific antibody titers were obtained prior to the 2nd and 3rd vaccination to assess primary and secondary antibody responses. Clinical protection status (anti-hepatitis B surface antigen immunoglobulin G ≥ 10 mIU/ml) was assessed 6 mo after the final immunization. Regression analyses revealed that shorter actigraphy-based sleep duration was associated with a lower secondary antibody response independent of age, sex, body mass index, and response to the initial immunization. Shorter sleep duration, measured by actigraphy and sleep diary, also predicted a decreased likelihood of being clinically protected from hepatitis B at the conclusion of the vaccination series. Neither sleep efficiency nor subjective sleep quality were significant predictors of antibody response.
Short sleep duration in the natural environment may negatively affect in vivo antibody responses to novel antigens, providing a possible explanation for observed associations of poor sleep with increased susceptibility to infectious disease.
Prather AA; Hall M; Fury JM; Ross DC; Muldoon MF; Cohen S; Marsland AL. Sleep and antibody response to hepatitis B vaccination. SLEEP 2012;35(8):1063-1069.